Individual
MCKENZIE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-2000
Mailing address
4025 N 92ND ST, WAUWATOSA, WI 53222-1613
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3859-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100059170
—
WI
Enumeration date
08/02/2016
Last updated
04/03/2024
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